Organization
SC DHEC
Active
Organization
SC DHEC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEAH WILLIS RN (PROGRAM DIRECTOR)
(843) 870-1321
Entity
Organization
Contact information
Practice address
4050 BRIDGE VIEW DR, SUITE 600, N CHARLESTON, SC 29405-7488
(843) 953-0272
Mailing address
4050 BRIDGE VIEW DR, SUITE 600, N CHARLESTON, SC 29405-7488
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
60412
SC
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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